| NPI | 1972230530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEVIEVE F CORREA Owner 808-650-2339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QR1300X Clinic/Center, Rural Health | |
| Enumeration Date | 2022-08-04 |
| Last Update Date | 2022-08-04 |